Chronic migraine diagnostic criteria

Description:

Headache occurring on 15 or more days per month for more than three months, which has the features of migraine headache on at least eight days per month.

Diagnostic criteria:

A. Headache (tension-type-like and/or migraine-like) on 15 or more days per month for more than three months and fulfilling criteria B and C

B. Occurring in a patient who has had at least five attacks fulfilling the following criteria for migraine without aura (B1) and/or migraine with aura (B2)

B1. Migraine without aura:

B1a. Headache attacks lasting 4 to 72 hours (untreated or unsuccessfully treated)

B1b. Headache has at least two of the following characteristics:

Unilateral location
Pulsating quality
Moderate or severe pain intensity
Aggravation by or causing avoidance of routine physical activity (eg, walking or climbing stairs)

B1c. During headache at least one of the following:

Nausea and/or vomiting
Photophobia and phonophobia

B2. Migraine with aura:

B2a. One or more of the following fully reversible aura symptoms:

Visual
Sensory
Speech and/or language
Motor
Brainstem
Retinal

B2b. At least two of the following characteristics:

At least one aura symptom spreads gradually over ≥5 minutes
Two or more aura symptoms occur in succession
Each individual aura symptom lasts 5 to 60 minutes
At least one aura symptom is unilateral
At least one aura symptom is positive
The aura is accompanied, or followed within 60 minutes, by headache

C. On eight days or more per month for more than three months, fulfilling any of the following:

Criteria B1b and B1c for migraine without aura
Criteria B2a and B2b for migraine with aura
Believed by the patient to be migraine at onset and relieved by a triptan or ergot derivative

D. Not better accounted for by another ICHD-3 diagnosis

ICHD-3: International Classification of Headache Disorders, 3rd edition.

Reproduced with permission of the International Headache Society. From: Headache Classification Committee of the International Headache Society (IHS). The International Classification of Headache Disorders, 3rd edition. Cephalalgia 2018; 38:1. Copyright © 2018 International Headache Society. https://ihs-headache.org/en/. https://journals.sagepub.com/home/cep.

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Chronic migraine diagnostic criteria